Alkaline urine

Since dietary cereals are low in sulfur-containing amino acids, they produce an alkaline urine which favors the retention of bone minerals. In post-menopausal women, there appears to be some interaction between the diet and the effect produced by estrogens on bone mineral content (28). 

The use of CA inhibitors as diuretics is limited by their propensity to cause metabolic acidosis and hypokalemia. Their use can be indicated in patients with metabolic alkalosis and secondary hyperaldosteronism resulting for example from aggressive use of loop diuretics. Furthermore, CA inhibitors are effective dtugs to produce a relatively alkaline urine for the treatment of cysteine and uric acid stones as well as for the accelerated excretion of salicylates. Perhaps the most common use of CA inhibitors is in the treatment of glaucoma. 

Although it has not been proven that acidification of the urine to increase PCP excretion alters the duration of the symptoms of psychosis, it appears appropriate to facilitate excretion of PCP from the adipose tissue in which it is stored in any PCP user (Done 1980). Maintaining the urine pH at an acid level for several weeks, even though the mental status is normal, is advised. It is important to test the pH of the urine to ensure compliance with the acidification. We have found that PCP becomes detectable in acidified urine for a time, even after being undetectable in alkaline urine, in previously intoxicated individuals. We have not found a change in mental status to result from such acidification treatment and resultant enhanced PCP excretion. 

Alkaline urine, possibly secondary to Proteus sp. infection, postrenal obstruction... 

The lacto-ovo vegetarian diet that these S.D.A. women follow would produce a slightly alkaline urine compared with the acidic urine associated with the consumption of. a meat diet. 

Methamphetamine - Methamphetamine is rapidly absorbed from the Gl tract. The primary site of metabolism is in the liver. The biological half-life is in the range of 4 to 5 hours. Excretion occurs in the urine and is dependent on urine pH. Alkaline urine increases the drug half-life. 

Urinary alkalinization- Urates tend to crystallize out of an acid urine therefore, a liberal fluid intake is recommended, as well as sufficient sodium bicarbonate (3 to 7.5 g/day) or potassium citrate (7.5 g/day) to maintain an alkaline urine continue alkalization until the serum uric acid level returns to normal limits and tophaceous deposits disappear. Thereafter, urinary alkalization and the restriction of purine-producing foods may be relaxed. 

Memantine (Namenda) [Anti Alzheimer Agent/NMDA Receptor Antagonist] Uses Mod/ evere Alzheimer Dz Action N-methyl-D-aspartate recqjtor antagonist Dose Target 20 mg/d, start 5 mg/d, t 5 mg/d to 20 mg/d, wait >1 wk before t dose use doses if >5mg/d Caution [B, /-] Hqjatic/mild-mod renal impair Disp Tabs, sol SE Dizziness Interactions t Effects W amantadine, carbonic anhydrase inhibitors, dextromethorphan, ketamine, Na bicarbonate t effects W/ any drug, herb, food that alkalinizes urine EMS Use NaHCOs w/ caution OD May cause restlessness, hallucinations, drowsiness, and fainting symptomatic and supportive... 

A higher proportion of salicylate is ionized in alkaline urine, and ionized salicylate is not reabsorbed. Urine can be made alkaline to pH 8-8.5 by giving sodium bicarbonate 100 mM in glucose 5% solution 1 litre at 100-200 ml/h. Overhydration can provoke pulmonary oedema, especially in seriously poisoned patients. 

Renal function, urine pH because alkaline urine may lead to an accumulation of the drug and a possible increase in side effects... 

Pharmacokinetics Rapidly and completely absorbed following oral administration. Protein binding High. Extensively metabolized in liver. Excreted in urine. Excretion is dependent upon urinary pH and is increased in alkaline urine. Half-life 3-8 hr (dose-dependent). 

The development of sulfonamide carbonic anhydrase inhibitors was based on the observation that antibacterial sulfanilamides produce alkaline urine. This discovery led to the development of acetazolamide (8.29), a thiadiazole derivative. It is not an ideal drug because it promotes K+ excretion and causes a very high urine pH. Since chloride ions are not excreted simultaneously, systemic acidosis also results. Much more useful are the chlorothiazide (8.30) derivatives, which are widely used as oral diuretic drugs. These compounds differ from one another mainly in the nature of the substituent on C3 ... 

Ammonium chloride increases urinary volume with acidification of urine. The excretion of amphetamine is decreased in relatively alkaline urine and has proved useful in the treatment of amphetamine intoxication. ... 

Thus, sulfadiazine is much more effectively trapped and excreted in alkaline urine. 

On the other hand, acidic drugs tend to ionize under conditions of alkaline pH and so are unable to permeate the renal tubular epithelium and are preferentially excreted. Tire converse applies to conditions of acidic urinary pH. This has been demonstrated experimentally for many drugs weak bases are excreted more rapidly in acidic urine, whereas weak acids are excreted more rapidly in alkaline urine. In the horse, phenylbutazone, which is a weak organic acid with a pKa of 4.6, has a more delayed clearance time under conditions of aciduria than under conditions of alkaline urine. 

Lockett (36, 37) has described two compounds, base A and base B. Base A occurred in the urine of men (who smoked), women (who did not smoke), and bitches. There was approximately three times as much in the urine of men and bitches as of women. The base was somewhat more active pharmacologically than Z-nicotine, and was found to exert its pressor effect through the mediation of the corpus striatum and thalamus, stimulating the sympathetic nervous system (38). Base A could be converted to -nicotine by drying in a high vacuum, with alteration of its action from a central to a peripheral one therefore it must be very similar in structure to nicotine. Base B was a different compound, also with pressor activity both were obtained by steam distillation from strongly alkaline urine. Furthermore, another compound, which she called base x, appeared in the... 

Other drugs that change the color of the urine act as follows. Logwood (hematoxylon) does not color acid urine but produces a reddish or violet color in alkaline urine. Santonin imparts a yellowish color to acid urine, with a yellow foam if the urine is made alkaline, it imparts a very pronounced pink color. Picric acid gives reddish-brown color in both acid and alkaline urine. The various coal-tar products give a brownish-black color. Methylene blue imparts a green color. 

The misuse of any of these agents has been shown to cause hypokalemia, dehydration, and a cathartic colon (resembling ulcerative colitis). Phenolphthalein-containing products may color alkaline urine red. 

The action of methenamine mandelate or hippurate is nonspecific against many different microorganisms and consists of the simultaneous effects of formaldehyde and acidity. Microorganisms such as proteus that make a strongly alkaline urine through release of ammonia... 

Quinidine Antacids and alkaline diet (alkaline urine) Quinidine toxicity... 

Which disorder is most likely to produce an alkaline urine (pH > 7) ... 

Drugs that alter the pH of urine can significantly affect the renal excretion of other drugs. Acid urine increases the effectiveness of mercurial diuretics. It also accelerates the excretion of basic drugs such as meperidine, tricyclic antidepressants, amphetamines, and antihistamines. Acidic drugs, such as aspirin, streptomycin, phenobarbital, sulfonamides, nalidixic acid, and nitrofurantoin have been shown to increase renal clearance in alkaline urine (61). The possible effects of urine pH on the renal excretion of drugs has been illustrated by the observation that if urine is rendered sufficiently alkaline, the excretion of amphetamine is markedly delayed and effective blood levels, after a single dose, can be maintained for several days (62). 

FLECAINIDE SODIUM BICARBONATE Urinary alkalinization t flecainide levels Flecainide excretion is 1 in the presence of an alkaline urine flecainide exists in predominantly non-ionic form, which is more readily reabsorbed from the renal tubules Monitor PR and BP closely... 

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